Africa is bracing for the worst, but has few ventilators

Israeli innovators want to help Africans breathe through COVID-19

Medics and engineers can make ventilators with basic parts costing $500 and a downloaded blueprint designed in Israel

Nathan Jeffay is The Times of Israel's health and science correspondent

A woman and her daughter wearing face masks to protect against coronavirus sell fruit and vegetables at the taxi station in Lenasia, south of Johannesburg, South Africa, April 8, 2020. (AP Photo/Themba Hadebe)
A woman and her daughter wearing face masks to protect against coronavirus sell fruit and vegetables at the taxi station in Lenasia, south of Johannesburg, South Africa, April 8, 2020. (AP Photo/Themba Hadebe)

With fears of ventilator shortages still growing, 300 businesses and nonprofit groups around the world are gearing up to produce breathing support machines using an Israeli DIY design they downloaded from the internet.

Its inventors, who are drawn from the tech, military and medical sectors, say they think their blueprint for a ventilator that can be produced for as little as $500 could avert a collapse of health care systems in Africa, where the coronavirus is expected to strike hard soon. Some of the parts can be 3D-printed straight from the online design.

“This can ventilate millions in Africa when no other machine is around,” said innovation consultant Eitan Eliram, commenting: “In Africa, they haven’t fully woken up to the coronavirus and there are hardly any ventilators, so this can make a huge difference.”

In fact, there are fewer ventilators in the whole of Africa than in Israel. Just 2,000 working machines serve 41 African countries, and ten African countries have none, according to the World Health Organization. Experts are warning that Africa is three weeks behind Europe in spread of the pandemic, and, according to a new report by the UN Economic Commission for Africa, even in a best-case scenario, the continent will face 122 million infections.

Teams around the world are talking to innovators at the new nonprofit AmboVent about their eponymous ventilator, as they build prototypes. Eliram, co-founder of AmboVent, said that some of the teams will be in mass production within a month.

Eitan Eliram, co-founder of AmboVent (courtesy)

It is one of several open-source ventilator designs generating excitement. The Massachusetts Institute of Technology has just released a plan for motorizing a manual emergency resuscitator bag.

Over the next few days, AmboVent is launching a crowdfunding campaign to cover a small production run of its machines in Israel so they can send a sample to each team for use as a reference guide, which will allow them to speed up their work. Eliram said they are launching this drive because they are “trying hard to run faster than the virus can kill.”

He predicted that even developing countries that have money to buy regular ventilators may end up building open-source designs.

“The situation with ventilators is dire,” he said. “Even with some of the ventilators you can get, you can’t get the valves anymore, so people are calling and saying we want this machine that isn’t dependent on sourcing supplies after it is made.”

Yuval Eran, a paramedic who worked on the original design and now spends hours every day trying to improve it, said he is moved by its popularity.

“I’m excited and thrilled,” he told The Times of Israel. “I am happy that it has given people hope, and this drives the AmboVent team to keep pushing forward.” Beyond companies and nonprofit groups that have committed to building prototypes, people from around the world have been in contact with inquiries — including several Iranians.

Yuval Eran working on a prototype of the AmboVent (courtsey)

In one of many messages AmboVent has received, Sergio Rivera, chief technology officer at the Mexican underwater robotics company AQUA Exploración, wrote that he feared that if Mexicans don’t “rise to the challenge,” his country could follow badly hit Ecuador, where ventilator shortages have been reported.

He wrote that as his government welcomes private sector initiatives, he is assembling a multidisciplinary team and wants to learn from the “amazing work” of AmboVent designers.

The blueprint was downloaded 19,000 times in its first hour online, but Eran said he still didn’t expect that three weeks later there would be 300 teams actually following it to build prototypes, and planning to produce them for hospitals. “It’s a solution that is much more needed even than I thought,” he said.

As Eran, a medical engineering student who works at Magen David Adom and volunteers with the FIRST robotics organization, works on improvements to the design, the teams building it in the US, England, Switzerland, Ukraine, Guatemala, Pakistan, New Zealand and elsewhere are doing the same.

“This is the whole idea of open source designs, not that we publish and it’s finished, but rather that we carry on improving as a team effort together with people in other countries,” he said, adding that a “global community” is now collaborating.

Soon after the coronavirus outbreak, as fears were growing that ventilator shortages would lead to elevated death counts, an ad hoc team formed consisting of members from Magen David Adom, the Israeli Air Force, Microsoft Israel, FIRST, the Tel Aviv Sourasky Medical Center, Hadassah Medical Center, and some other players. It was determined to come up with a design for an easy-to-build ventilator to share with the world.

It is not a full-function machine, but rather what Eran calls a “stopgap solution for when you need a Plan B to survive this situation.” It is similar to the bag-valve mask ventilators that paramedics use if they need to give respiratory support in an ambulance, but with extra functions. It connects to an intubation tube that is inserted into patients who are unable to breathe on their own.

An AmboVent prototype (courtesy)

The AmboVent uses parts that can be found in any hospital, and in the case of some items, even car mechanics’ warehouses. Eran said this captures the spirit of Israeli innovation, adding that he has been encouraging this type of problem-solving for years as a volunteer with FIRST, and is excited that it could save lives. “This whole project has a huge resemblance to what we, as mentors at the FIRST program, do every year,” he said.

Eliram said that some of the foreign teams that are making contacts say that low-cost ventilators are essential for doctors’ sanity as well as patients’ health. He reported: “In some places we hear that doctors need this for their sanity because they can’t cope with the decisions of who gets ventilators.”

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